Individual
DR. JEAN L OLIVER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1909 GRANBY ST, NORFOLK, VA 23517-2349
(757) 640-0022
(757) 627-8064
Mailing address
1909 A GRANBY ST, NORFOLK, VA 23517-2349
(757) 640-0022
(757) 627-8064
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101055343
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11902
OPTIMA
VA
01
—
243512
ANTHEM
VA
Enumeration date
05/04/2006
Last updated
07/08/2007
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